Oklahoma Senate Bill 1500 was introduced, which would require PBMs to pay pharmacy bills within 30 days, presenting conflicts between the PBM oversight law and workers' compensation statutes, which enable payers to utilize a 45-day timeframe to pay an undisputed medical bill.

Healthesystems will be engaging with legislators to seek an exclusion from this duplicative and conflicting payment requirement. 

Meanwhile, Oklahoma House Bill 4457 was introduced, which would prohibit pharmacy benefit managers (PBMs) from owning, operating, or holding a direct or indirect ownership interest in a retail or mail‑order pharmacy in the state, including mail order or specialty pharmacies.

This bill is now under legal challenge from the PBM industry and other interested parties, as it is modeled after Arkansas Act 624, which passed in 2025, but was hit with a preliminary injunction by an Arkansas court. The injunction blocked enforcement of the Act’s many provisions, after which legal experts found Act 624 likely violates the Constitutional Commerce Clause and is preempted by federal TRICARE law. 

The court has yet to decide the merits of the case. Consequently, the likelihood of this legislation advancing as a complete ownership ban in other states is low. Instead, it is more plausible that disclosure requirements or a study bill on the issue will be adopted. Should this type of legislation gain traction across states, numerous pharmacies might be forced to close, or ownership stakes would need to be divested to other entities. This could result in fewer pharmacies, particularly impacting rural communities disproportionately.